Conduct periodic audits of patient information to identify and address discrepancies or inconsistencies, ensuring data accuracy and integrity within the practice’s systems. With the rise of HDHPs, patients bear more out-of-pocket costs, leading to increased AR and delayed payments. You can use the resulting percentage to check your current policies and procedures. Hospitals and clinics can also prioritize the verification of demographic entries to optimize their reimbursement process. You can also focus on verifying accurate details of key medical processes like patient registration and scheduling. This step includes a constant review of your accounts receivable to analyze their aging and identify the overdue ones among them.
Medical Coding
Offering multiple payment options, such as online payments, credit card payments, and interest-free payment plans, helps patients pay their medical bills on time. Add to that the time and expense of processing invoices manually, routing payment documents for approval, and sending out payment reminders. Clearly, outdated workflows and operations end up costing a healthcare organization more than upgrading to a modern, automated solution. This conversation should be handled with sensitivity and compassion from staff prior to notifying patients.
Understand the costs
With this data, you can make better decisions about providing your services to specific patients. Medical Billers and Coders (MBC) has been providing account receivable services to clients across the USA. Our highly experienced team of AR specialists has worked with different insurance companies and is well-acquainted with all their policies. If you have a lot of accounts receivable payments that need to be collect, feel free to get in touch with our AR Team.
The Growing Challenge of Claim Denials and Delayed Reimbursement on Healthcare Providers
I am a curious individual by nature, driven by passion and I translate that into my Bookkeeping 101 writings. From tracking overdue claims to prioritizing follow-ups, the aging report is more than just a report—it’s your financial playbook. In this guide, we’ll take you through everything you need to know to make the most of this essential resource. Billing challenges, recovery rates and partnership options will vary based on this simple division of accounts. Before engaging a potential partner, organizations should follow a series of systematic steps to see if a strategic A/R partner is right for them, beginning with identifying a more specific need.
The Importance of Effective AR Management
Moreover, well-managed AR processes minimize the risk of unpaid or overdue accounts, reducing financial losses and enhancing the overall profitability of the practice. There you’ll find more information on benchmarks, and questions to ask a billing department. And if you’re hesitant to seek outside help, take a look at our Case Studies and ROI to get an idea of how investing in the services of a qualified medical billing consultant can pay off handsomely. The other measure is the percent of accounts receivable in each “aging bucket”, for instance, 0-30 days, days, days, etc. To calculate it, you will need a report showing the dollar amount of the AR in each aging bucket. The graph below shows the contrast between Better-performing billing departments vs. Average-performing billing departments.
Considering that a 2024 report found that 84% of healthcare businesses lost money due to outdated AR practices, this is clearly a message that needs spreading. These reports are useful for setting up department specific goals, and viewing individual level productivity data. Accounts receivable for medical practices—sometimes referred to as healthcare A/R—refers to the total amount of money patients, payers, or both owe you. In healthcare, there’s always a lag between the time you render services and when you’re ultimately paid. However, the goal is to shorten that time—to strive for the lowest days in A/R. Otherwise, ongoing expenses will continually outweigh profits, and it will be nearly impossible to get ahead and promote financial sustainability.
What is Accounts Receivable (A/R) in Healthcare and How to Improve It?
- Insurance verification reduces claim denials and rejections, resulting in timely payments.
- Co-insurance, a percentage of the allowed charge, also falls under this category.
- Providers can better plan their budgets and direct resources where they are most needed by cutting down on the number of days outstanding.
- A higher claim denial rate means the organization has lost a huge sum of money that impacts the overall financial health of the facility.
- The sooner the collection follow-up of claims begins, the faster they’ll be resolved.
The exercise should be combined with the other breakouts detailed below to find ideal candidates for offloading populations. The next big risk we see emerging from our AR risk analyses is inadequate processes. Since processes and internal controls are closely linked, a problem with process usually means another internal control needs to be put in place to make sure it doesn’t continue going forward. ExpressMED, an occupational medicine and urgent care provider in New Hampshire, streamlined its operations with PrognoCIS EHR, saving about 10 hours per week per location. By collaborating with specialists, suppliers can access qualified experts who are just interested in AR optimization.
Secure Funding with EPOCH Financial Today
However, if you unnecessarily write off payments, that you can recover through effective A/R management, you will strain your practice’s revenue cycle. Through knowledge of the accounts receivable log for individual patients contracting process will result in better negotiations of managed care contracts. It entails knowing reimbursement rates, effective and termination dates, claim filing guidelines, payment terms, and other contract provisions. Despite the fact that every health organization’ s contract negotiation strategy is unique and based on multiple factors, the fundamentals should always be borne in mind. Another aspect of an efficient AR management team is understanding contracts that regulate providers financial relationships with managed care organizations.
A disorganized collection process can What is bookkeeping be the result of inadequate staffing, poor training, or inadequate technology. Our team reduces A/R backlogs by implementing industry best practices and streamlining processes. At PCH Health, we prioritize claims based on service date, payer mix, and dollar value to ensure swift handling.
Claims scrubbing is an important step in this context that helps ensure the claim contains all relevant details, and that there are no typographical errors, illegible content, or duplicate charges. Scrubbing helps to identify and correct errors, such as incorrect coding, missing patient information, or incomplete documentation. Claims scrubbing can also help to ensure compliance with regulatory requirements, such as HIPAA.